Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK.
Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
Blood Cancer J. 2021 Jul 30;11(7):136. doi: 10.1038/s41408-021-00528-x.
B-cell chronic lymphocytic leukaemia (CLL) is associated with immunosuppression and patients are at increased clinical risk following SARS-CoV-2 infection. Covid-19 vaccines offer the potential for protection against severe infection but relatively little is known regarding the profile of the antibody response following first or second vaccination. We studied spike-specific antibody responses following first and/or second Covid-19 vaccination in 299 patients with CLL compared with healthy donors. 286 patients underwent extended interval (10-12 week) vaccination. 154 patients received the BNT162b2 mRNA vaccine and 145 patients received ChAdOx1. Blood samples were taken either by venepuncture or as dried blood spots on filter paper. Spike-specific antibody responses were detectable in 34% of patients with CLL after one vaccine (n = 267) compared to 94% in healthy donors with antibody titres 104-fold lower in the patient group. Antibody responses increased to 75% after second vaccine (n = 55), compared to 100% in healthy donors, although titres remained lower. Multivariate analysis showed that current treatment with BTK inhibitors or IgA deficiency were independently associated with failure to generate an antibody response after the second vaccine. This work supports the need for optimisation of vaccination strategy in patients with CLL including the potential utility of booster vaccines.
B 细胞慢性淋巴细胞白血病（CLL）与免疫抑制有关，SARS-CoV-2 感染后患者的临床风险增加。Covid-19 疫苗具有预防严重感染的潜力，但对于首次或第二次接种后抗体反应的特征知之甚少。我们研究了 299 例 CLL 患者与健康供体相比，首次和/或第二次 Covid-19 接种后刺突特异性抗体反应。286 例患者接受了延长间隔（10-12 周）接种。154 例患者接受了 BNT162b2 mRNA 疫苗，145 例患者接受了 ChAdOx1。通过静脉穿刺或滤纸的干血斑采集血液样本。与健康供体相比，首次接种后，34%的 CLL 患者（n=267）可检测到刺突特异性抗体反应，而健康供体的抗体滴度低 104 倍。第二次接种后，抗体反应增加到 75%（n=55），而健康供体为 100%，尽管滴度仍然较低。多变量分析表明，目前使用 BTK 抑制剂或 IgA 缺乏与第二次接种后无法产生抗体反应独立相关。这项工作支持优化 CLL 患者的疫苗接种策略，包括使用加强疫苗的潜在效用。
